Roche’s First-in-Class Werner Helicase Inhibitor Shows Early Promise in Phase I Cancer Trial

This drug works similarly to other DNA damage repair inhibitors, such as PARP inhibitors.
A presentation slide titled abstract CT016 and about First-in-Class Werner Helicase Inhibitor.
First-in-Class Werner Helicase inhibitor. RO7589831 Proof-of-Concept study in phase I clinical trial.Newswise
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The results were presented today in the clinical trials plenary session at the American Association for Cancer Research (AACR) Annual Meeting 2025 by principal investigator Timothy Yap, M.B.B.S., Ph.D., professor of Investigational Cancer Therapeutics and vice president and head of clinical development in MD Anderson’s Therapeutics Discovery division.

Though this targeted therapy is the first in a new class of drugs, it is part of a wider group of therapies targeting the DNA damage response for patients with solid tumors and genetic changes known as high microsatellite instability (MSI) or deficient mismatch repair (dMMR). These can occur in many cancer types, and 40-70% of patients with these types of solid tumors either do not respond to immune checkpoint inhibitors or develop resistance during treatment.

"RO7589831 appears generally safe and shows promising signals of anti-tumor efficacy. These are encouraging early clinical data, especially because this is a patient population that currently has very limited treatment options. This also further validates Werner helicase as an actionable target, which is exciting because many cancers are highly dependent on it for survival."

Timothy Yap, M.B.B.S., Ph.D., professor of Investigational Cancer Therapeutics

A research scientist wearing purple gloves, holding a test tube with drug in the hand.
Encouraging early results in this first-in-human trial prompted additional trial cohorts to optimize recommended dose for future clinical development.Unsplash

Like other DNA damage response therapies, RO7589831 inhibits the function of a DNA repair enzyme, in this case Werner helicase, to create a buildup of DNA damage within tumor cells, ultimately leading to cell death. Because normal cells do not have MSI, these treatments spare normal cells.

Initial efficacy was evaluated in 37 patients. Five of these patients, representing multiple cancer types with high MSI or dMMR, had partial responses as determined by radiological imaging, and 65.7% of all patients had lasting stable disease. Specialized metabolic imaging showed that deeper metabolic responses were associated with both radiological partial responses and longer-term disease control.

Safety was evaluated in 44 patients, with the majority experiencing grade 1-2 adverse events, though higher doses appeared less tolerable than lower doses. Mild manageable nausea, vomiting and diarrhea were the most common adverse events, and no dose-limiting toxicities were observed.

Three randomized dose-level cohorts are underway to establish the optimal recommended dose for a future Phase II trial. This trial was funded by Roche.

(Newswise/HB)

A presentation slide titled abstract CT016 and about First-in-Class Werner Helicase Inhibitor.
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